technetium-tc-99m-sulfur-colloid and chromic-phosphate

Topics: Antineoplastic Combined Chemotherapy Protocols; Chromium Compounds; Combined Modality Therapy; Female; Humans; Injections, Intraperitoneal; Neoplasm Staging; Ovarian Neoplasms; Palliative Care; Phosphates; Phosphorus Radioisotopes; Radiopharmaceuticals; Radiotherapy; Radiotherapy Dosage; Randomized Controlled Trials as Topic; Salvage Therapy; Technetium Tc 99m Sulfur Colloid

This study addressed the technique of intraperitoneal distribution imaging (IDI). A literature search (MEDLINE database) revealed wide variations in IDI techniques without a basis for comparison. From April 1990 to September 1992, the authors studied 8 patients (age 43-65 years) with ovarian cancer. A total of 1000 ml of normal saline and 1 mCi of Tc-99m SC was infused intraperitoneally for IDI. In one patient loculation was observed, but only 250 ml of normal saline was infused with Tc-99m SC. A repeat study using our standard technique rendered free intraperitoneal distribution in this patient, as well as in the other seven cases. Some investigators recommend low volumes, but in our experience this produced the finding of pseudoloculation, which could change treatment inappropriately. Although the number of patients studied at our institution was small, administration of 1 liter intraperitoneally provided consistent IDI results.

Topics: Chromium Compounds; Female; Humans; Infusions, Parenteral; Middle Aged; Ovarian Neoplasms; Peritoneal Cavity; Phosphates; Phosphorus Radioisotopes; Radionuclide Imaging; Sodium Chloride; Technetium Tc 99m Sulfur Colloid; Tissue Distribution

A patient with postoperative Stage I ovarian carcinoma received 15 mCi of 32P-chromic phosphate suspension in normal saline intraperitoneally as part of her therapy. The following day, a portion of the infused radiopharmaceutical and normal saline had passed transdiaphragmatically into the patient's right pleural cavity. Thoracentesis removed as much fluid as possible and this fluid contained radioactive material. In the ensuing 4 yr, the patient has not manifested any detectable pleural or pulmonary abnormalities attributable to the radioactivity. Retrospective review of 100 consecutive patients receiving 32P-chromic phosphate intraperitoneal therapy resulted in 43 patients in whom the hemithoraces could be evaluated scintigraphically. Three of the 43 patients (7%) had right pleural fluid radioactivity. This is similar to the percentages reported in patients with cirrhosis with ascites in whom hepatic hydrothorax is identified.

Topics: Chromium Compounds; Extravasation of Diagnostic and Therapeutic Materials; Female; Humans; Infusions, Parenteral; Middle Aged; Ovarian Neoplasms; Peritoneal Cavity; Phosphates; Phosphorus Radioisotopes; Pleura; Pleural Effusion; Technetium Tc 99m Sulfur Colloid; Time Factors; Tissue Distribution

Radionuclide peritoneoscintigraphy has been used prior to chromic phosphate P-32 (P-32CP) intraperitoneal therapy to assure proper placement of the catheter in the peritoneal cavity, to exclude loculation, and to predict inadequate distribution of P-32CP. This is a case report of the detection of a peritoneal catheter improperly placed into the bowel lumen by pretherapy radionuclide peritoneoscintigraphy, and this case demonstrates the distinguishing characteristics of the radiocolloid distribution secondary to an intraluminal injection relative to an intraperitoneal injection.

Topics: Adenocarcinoma; Brachytherapy; Catheterization; Chromium; Chromium Compounds; Colonic Neoplasms; Female; Humans; Middle Aged; Peritoneal Cavity; Peritoneal Neoplasms; Phosphates; Phosphorus Radioisotopes; Radionuclide Imaging; Technetium Tc 99m Sulfur Colloid

Seven patients received intraperitoneal chromic phosphate (32P) suspension in a 3-ml bolus with a saline flush, and another ten patients were given the suspension in a 500-ml infusion of normal saline. During the first six hours after administration, most 32P activity redistributed to the gravity-dependent portion of the peritoneal cavity. From 24 hours up to seven weeks after administration, activity distributions were fixed. Dispersions were heterogeneous in every patient, but the most marked examples of localized activity occurred in patients who had received bolus injections. We concluded that large-volume infusions and frequent changes in patient position for several hours following the infusion, contribute to improved dispersion of 32P suspension.

Topics: Chromium; Chromium Compounds; Female; Humans; Ovarian Neoplasms; Peritoneal Cavity; Phosphates; Posture; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Time Factors; Tissue Distribution

Topics: Bronchial Fistula; Chromium; Chromium Compounds; Fistula; Humans; Male; Middle Aged; Phosphates; Phosphorus Radioisotopes; Pleural Diseases; Pleural Effusion; Radionuclide Imaging; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid